The Republicans have unveiled their health care plan – The American Health Care Act. It took seven years. And nobody, except its authors, like it. So let’s give it a review. Unlike most politicians, I don’t pretend to be an expert on healthcare. But even an amateur can see four things.
One, the individual mandate is gone. And with it, the bulk of healthy young adults needed to keep the average costs down. Two, financial assistance to the poor goes down and to the rich goes up. Three, the Medicaid expansion is capped, and matching federal payments to states end. Four, whatever you do, don’t get oldish. If you haven’t made it to Medicare yet, your costs just skyrocketed
But even this abuse of the weakest is too much for the ‘soak the poor’ crowd. These conservative zealots claimed that the GOP monstrosity is ‘Obamacare Lite’. Its sin? There was still some financial assistance for the less well off.
The religious crowd did manage to get their ‘hurt the poor’ policy into the act. The bill defunds Planned Parenthood. Trump offered to restore PP’s funding if they stopped performing abortions. Which shows that Republicans – despite their laissez-faire claims to the contrary – are only too happy to interfere with health care. Get between a woman and her doctor? Yes, please.
Planned Parenthood, to its credit, told Trump to bugger off. After all, abortion is a legal and constitutionally guaranteed procedure in the US. And no federal funds go to performing abortions.
What will become of the bill? There are four possible outcomes. It will pass as written. It will be revised and pass. It will be bogged down in endless talk. It will be forgotten.
Pass as written is unlikely. There’s no guarantee it will make it through the House, and the Senate already looks dodgy. House members have to watch out for primary challenges from the right. In safe districts the general election is irrelevant. And Senators have to be elected by entire states – not by gerrymandered partisan districts – which means they have to be sensitive to a broad swathe of voters.
Pass with revisions? Maybe. But House members will want it to be more extreme, and Senators will want it to be more generous. So it’s hard to see where a compromise would be.
Bogged down in endless talk? This is the most likely scenario. It plays to two Republican strengths – inertia and prolixity.
Forgotten? This is what a good number of Republicans wish. For years they could act like sniggering little boys throwing stones. But now they have to build something. And that isn’t in their wheelhouse. Unfortunately for them, the genie is out of the bottle.
The Republicans have always had to contend with the same difficulty. Their policies only benefit a few. Yet they have to get votes. So far they have done brilliantly by distracting the white working class voter with chat of criminal immigrants, ‘religious freedom’, trans in bathrooms, terrorism, and job creation.
But there is a difference between giving the rich a tax cut – which the poor won’t feel directly – and taking away someone’s healthcare – which you can bet the poor will notice.
Making it worse is Trump’s promise that heath insurance would be universal and cheaper. You can take it to the bank that those sound-bites will get a lot of air-time.
What will Republicans do? I don’t know. And I don’t think they do either.